Nationwide, about 10 percent of children have a communication disorder, including speech, language or hearing problems. Speech problems may resolve themselves as a child develops, or they may require professional help from a certified speech-language pathologist. Common speech problems include:

  • Articulation disorders – The difficulty producing clear speech sounds accounts for about 75 percent of all communication disorders. The three most common types are the substitution of one sound for another; omitting a sound (“cat” may be pronounced “ca”); and the slight distortion of a sound, as in lisping.
  • Language development disorders – These involve delays in expression, processing and comprehension. Children with expressive disorders may have a more limited vocabulary than their peers. They may have difficulty using correct words (substituting “mat” for “map” or “hat” for “scarf”, for example), or overusing nonspecific words, such as “like” or “stuff”.
  • Receptive (comprehension) disorders – Trouble following multistep instructions or figuring out intended meanings without the help of gestures and cues are symptoms of receptive disorders.
  • Voice disorders – When loudness, pitch or quality of voice is so unusual that it distracts listeners, pathologists consider this a voice disorder. Variations include hoarseness, harshness, breathiness and shrillness, speaking too loudly or too softly or at a pitch higher or lower than normal.
  • Fluency disorders – These involve disruptions in the rhythm and flow of speech, including pauses, hesitations, interjections, prolongation or repetition of syllables and interruptions. Stuttering is a normal part of early childhood but may require direct services if it continues past age 5.

You may have noticed some of these issues in your own young child; but keep in mind that while speech-language development happens in stages, the age at which a child will reach each stage varies, according to the American Speech-Language-Hearing Association (ASHA). It’s often hard to tell whether a child is a late-bloomer or has a speech problem. If you suspect your child has an issue, trust your gut and talk first to your pediatrician.

Tips for Parents

How can you help your child develop good listening and speech skills?

Speech pathologists Kenn Apel, Ph.D., and Julie Masterson Ph.D., authors of Beyond Baby Talk: From Speaking to Spelling: A Guide to Language and Literacy Development for Parents and Caregivers, by (Three Rivers Press, revised 2012), offer these tips:

  • Talk about what you are doing, what your child is doing and what your child sees.
  • Use a varied vocabulary. Children enjoy new and unusual words.
  • Give directions for your child to follow to encourage listening skills.
  • Don’t interrupt a child to correct speech. Say the sounds correctly when it’s your turn to talk.
  • Ask questions requiring more than “yes” or “no” answers.

Don’t wait to get help if you’re concerned about your child’s speech development. Early treatment can stop later problems with learning, behavior and social relationships.

Mary Alice Cookson is associate editor of the Boston Parents Paper. Writer Barbara Smith Decker also contributed to this article.